Cognitive trends in an urban Indian elderly community: Glycated hemoglobin and geriatric depression play a bigger role than age

ObjectivesTo explore the cognitive profile in urban Indian older adults and observe the prevalence of cognitive impairment associated with age, glycated hemoglobin (HbA1c) levels, vitamin B12, and other psychosocial factors MethodsUrban community dwelling older adults (55-85years, n=123) underwent a detailed demographic and cognitive assessment comprising of tests from different cognitive domains - memory, executive function, visuospatial abilities, and verbal fluency. Serum samples were collected from a subset of participants (n=60) to determine HbA1c and vitamin B12 levels. ResultsPerformance in all cognitive domains declined with age. The decline became prominent around age 70. HbA1c correlated inversely with processing speed and executive function. Vitamin B12 did not correlate with performance on any cognitive test. Geriatric depression correlated inversely with visuospatial abilities. Surprisingly, stepwise multiple regression revealed that HbA1c and geriatric depression contributed to 28% variance on Montreal Cognitive Assessment whereas participant age did not contribute significantly. Mild Cognitive Impairment (MCI) was observed in 17% of participants. Participants classified as MCI had higher levels of HbA1c and geriatric depression, and lower performance in all cognitive domains compared to non-MCI participants. ConclusionAlthough cognitive performance declined with age, HbA1c and geriatric depression played a greater role than age in predicting cognitive decline. This study highlights the prevalence of metabolism linked changes in cognition in community dwelling Indian older adults.